Do Postoperative Orthopedic Patients Accurately Report Their Narcotic Medication Usage Using the Interventional Pain Assessment Drugs Scale?

INTRODUCTION

Accurately assessing opioid consumption is critical for effective postoperative pain management and reducing misuse. While prescription monitoring tools like the Michigan Automated Prescription System (MAPS) provide objective data, they may not reflect actual patient behavior. This study evaluates the accuracy of self-reported opioid use using the Interventional Pain Assessment-Drugs (IPA-D) scale.

METHODS

A prospective IRB-approved study enrolled 753 postoperative orthopedic patients at a Level I trauma center from June 2022 to June 2023. Participants completed the IPA-D survey to self-report opioid usage, which was stratified into five classes based on morphine milligram equivalents (MMEs). These reports were compared to MAPS prescription data to determine classification accuracy.

RESULTS

The IPA-D scale demonstrated high accuracy. Classes A and B showed 100% accuracy with 0.0 MMEs. Class C (1-30 MMEs) had an accuracy of 99.3% with an average MME of 17.3. Class D (31-79 MMEs) reported 96.6% accuracy with an average MME of 42.81. Class E (≥80 MMEs) showed 94.4% accuracy and an average MME of 140.83.

CONCLUSION

The IPA-D scale enables reliable patient self-reporting of opioid use across most MME categories. It offers a practical, accurate tool for real-time opioid monitoring in clinical settings and may serve as a valuable complement to prescription databases like MAPS.